GET YOUR HOUSE CHECKED TODAT FOR A
SAFE HOME
AND PREVENTATIVE MAINTENANCE
FILL OUT THE BELOW
AK ELECTRIC
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number
Signed
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Option 1 - Electrical Safety Check - Smoke alarm service
Option 2 - Cleaner air service
SAFETY & COMPLIANCE REPORT
A digital & compliance report is provided for each service we carry out
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